The buried suture method of double eyelid operation is an operation to implant a foreign material of buried thread. Therefore, suture removal for a foreign material of buried thread needs to be taken into account. We have studied 63 cases of suture removal for the buried suture method. Suture removal is performed by means of puncture skin incision, small skin incision, total skin incision, or conjunctival approach. We have categorized 3 portions; skin-subcutaneous, intramuscular and pretarsal, according to the depth of buried thread knots. Threads were difficult to remove in cases that the operation was done by tarsal fixation method and buried thread knots were in front of tarsa. As for buried suture method by tarsal fixation method, corneal irritation was the reason for suture removal of buried thread. In some cases that buried thread knots existed in skin-subcutaneous, buried threads could be seen through the skin, which looked raised with papule, so that the patients requested it be improved aesthetically. They were easily removed. We assume that categorizing knots according to depth is clinically beneficial. We also assume that the muscle layer is an appropriate location for knots of buried threads.
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